Pub Date : 2026-01-01DOI: 10.1016/j.echo.2025.09.017
Lytfi Krasniqi MD , Christian Juhl Terkelsen MD, DMSc, PhD , Henrik Nissen MD, PhD , Philip Freeman MD, PhD , Christian Alcaraz Frederiksen MD, PhD , Henrik Vase MD, PhD , Kristian Hejlesen RN , Christian Byskov Fur MD , Troels Thim MD, PhD , Ashkan Eftekhari MD, PhD , Frederik Uttenthal MD , Julia Ellert MD, PhD , Nils Sofus Borg Mogensen MD, PhD , Amal Haujir MD , Evald Høj Christiansen MD, PhD , Jordi Sanchez Dahl MD, DMSc, PhD
Objective
The aim of this study was to study the impact of flow status on effective orifice area (EOA) in patients treated with the balloon-expandable Myval and Sapien transcatheter heart valves (THVs).
Methods
We collected the core laboratory-measured EOA, mean and peak gradients, Doppler velocity index (DVI), and stroke volume index (SVi) from the 30-day echocardiograms in patients treated with the balloon-expandable Myval and Sapien THVs in the COMPARE-TAVI 1 trial. Patients were stratified according to flow into low flow (SVi <35 mL/m2), normal flow (SVi 35-50 mL/m2), and high flow (SVi >50 mL/m2).
Results
A total of 1,031 patients were included in COMPARE-TAVI 1. Myval THVs (20.0-32.0 mm) exhibited overall higher mean EOA and lower mean gradients (1.99 ± 0.55 cm2, 9.46 ± 3.84 mm Hg) compared to Sapien THVs (20-29 mm; 1.81 ± 0.56 cm2, 11.47 ± 4.47 mm Hg). Compared to normal-flow patients, low-flow patients exhibited smaller EOA (P < .001) and lower DVI (P < .001) in all valve sizes irrespective of THV platform, while high-flow patients had larger EOA (P < .001) and higher DVI (P < .001). Female sex was associated with lower stroke volume, resulting in lower mean and peak gradients independent of valve size and platform (P < .001).
Conclusion
The study indicates that EOA may be underestimated after TAVI in patients with low-flow status, which can impact the assessment of prosthesis-patient mismatch.
{"title":"Impact of Flow Status on Effective Orifice Area in Transcatheter Heart Valves: A COMPARE-TAVI 1 Substudy","authors":"Lytfi Krasniqi MD , Christian Juhl Terkelsen MD, DMSc, PhD , Henrik Nissen MD, PhD , Philip Freeman MD, PhD , Christian Alcaraz Frederiksen MD, PhD , Henrik Vase MD, PhD , Kristian Hejlesen RN , Christian Byskov Fur MD , Troels Thim MD, PhD , Ashkan Eftekhari MD, PhD , Frederik Uttenthal MD , Julia Ellert MD, PhD , Nils Sofus Borg Mogensen MD, PhD , Amal Haujir MD , Evald Høj Christiansen MD, PhD , Jordi Sanchez Dahl MD, DMSc, PhD","doi":"10.1016/j.echo.2025.09.017","DOIUrl":"10.1016/j.echo.2025.09.017","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to study the impact of flow status on effective orifice area (EOA) in patients treated with the balloon-expandable Myval and Sapien transcatheter heart valves (THVs).</div></div><div><h3>Methods</h3><div>We collected the core laboratory-measured EOA, mean and peak gradients, Doppler velocity index (DVI), and stroke volume index (SVi) from the 30-day echocardiograms in patients treated with the balloon-expandable Myval and Sapien THVs in the COMPARE-TAVI 1 trial. Patients were stratified according to flow into low flow (SVi <35 mL/m<sup>2</sup>), normal flow (SVi 35-50 mL/m<sup>2</sup>), and high flow (SVi >50 mL/m<sup>2</sup>).</div></div><div><h3>Results</h3><div>A total of 1,031 patients were included in COMPARE-TAVI 1. Myval THVs (20.0-32.0 mm) exhibited overall higher mean EOA and lower mean gradients (1.99 ± 0.55 cm<sup>2</sup>, 9.46 ± 3.84 mm Hg) compared to Sapien THVs (20-29 mm; 1.81 ± 0.56 cm<sup>2</sup>, 11.47 ± 4.47 mm Hg). Compared to normal-flow patients, low-flow patients exhibited smaller EOA (<em>P</em> < .001) and lower DVI (<em>P</em> < .001) in all valve sizes irrespective of THV platform, while high-flow patients had larger EOA (<em>P</em> < .001) and higher DVI (<em>P</em> < .001). Female sex was associated with lower stroke volume, resulting in lower mean and peak gradients independent of valve size and platform (<em>P</em> < .001).</div></div><div><h3>Conclusion</h3><div>The study indicates that EOA may be underestimated after TAVI in patients with low-flow status, which can impact the assessment of prosthesis-patient mismatch.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 1","pages":"Pages 80-88"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/S0894-7317(25)00705-9
{"title":"Guide for Authors","authors":"","doi":"10.1016/S0894-7317(25)00705-9","DOIUrl":"10.1016/S0894-7317(25)00705-9","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 1","pages":"Pages A9-A18"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145852431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 2","pages":"Pages 167-178"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147097057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 2","pages":"Pages 237-238"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147097068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 2","pages":"Pages A1-A5"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147080130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 1","pages":"Pages A9-A18"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146460677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 1","pages":"Pages 1-14"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146460678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.echo.2025.08.019
Daniel O'Meara MD , Erik C. Michelfelder MD , Andrew Jergel MPH , Sanghee S. Ro MD
Background
Tricuspid regurgitation (TR) is commonly identified via fetal echocardiography (FE). The association of TR in the fetal heart with neonatal outcomes remains poorly understood. We aimed to assess the spectrum and evolution of non-Ebsteinoid TR in fetuses and to understand the associated clinical outcomes in the current era.
Methods
We conducted a retrospective cohort study of all fetuses diagnosed with non-Ebsteinoid TR at a single center from January 1, 2012, to October 1, 2023. Eligible fetuses were divided into 3 groups based on the severity of TR on initial FE: mild, moderate, and severe. Initial and serial FE were reviewed along with postnatal echocardiographic findings. Prenatal variables and neonatal outcomes were also collected.
Results
A total of 67 fetuses met the inclusion criteria. Based on initial FE, 49 (73.1%) fetuses had mild TR, 15 (22.4%) had moderate TR, and 3 (4.5%) had severe TR, diagnosed at a median gestational age of 26.3 weeks [23.4, 32.3]. Of fetuses with mild TR that had worsening TR in utero (17.9%) or postnatally (17.6%), all had tricuspid valve (TV) dysplasia or right ventricle (RV) dysfunction noted prenatally. Compared to fetuses with mild TR and normal TV anatomy, fetuses with mild TR and TV dysplasia had larger TV annuli (1.12 cm vs 0.96 cm; P = .035) and RV internal diameter in diastole (1.59 cm vs 1.26 cm; P = .01). Newborns with prenatally diagnosed severe TR were more likely to require cardiac intensive care after birth (3/3 = 100%; P < .001) than those with mild (1/49 = 2%) or moderate TR (1/15 = 6.7%).
Conclusions
In the absence of TV dysplasia or RV dysfunction, mild, non-Ebsteinoid fetal TR can be considered a benign finding in the current era. However, when these findings are present, or in the patient with limited imaging windows, postnatal evaluation should be performed to rule out other primary cardiac disease.
背景：三尖瓣反流（TR）通常通过胎儿超声心动图（FE）识别。胎儿心脏TR与新生儿结局的关系尚不清楚。我们的目的是评估胎儿非ebsteinoid TR的频谱和演变，并了解当前时代的相关临床结果。方法：我们对2012年1月1日至2023年10月1日在单一中心诊断为非ebsteinoid TR的所有胎儿进行了回顾性队列研究。根据初始FE的TR严重程度将符合条件的胎儿分为轻度、中度和重度3组。回顾了初始和连续FE以及产后超声心动图结果。还收集了产前变量和新生儿结局。结果：67例胎儿符合纳入标准。根据初始FE， 49例（73.1%）胎儿为轻度TR， 15例（22.4%）为中度TR， 3例（4.5%）为重度TR，诊断时中位胎龄为26.3周[23.4,32.3]。轻度TR胎儿在子宫（17.9%）或出生后（17.6%）TR恶化，所有三尖瓣（TV）发育不良或右心室（RV）功能障碍产前注意。与轻度TR和TV解剖正常的胎儿相比，轻度TR和TV发育不良的胎儿TV环空较大（1.12 cm vs 0.96 cm, P = 0.035），舒张期RV内径较大（1.59 cm vs 1.26 cm, P = 0.01）。产前诊断为重度TR的新生儿出生后需要心脏重症监护的可能性（3/3 = 100%;P < .001）高于轻度TR（1/49 = 2%）或中度TR（1/15 = 6.7%）的新生儿。结论：在没有TV发育不良或RV功能障碍的情况下，轻度、非ebsteinoid胎儿TR可被认为是一种良性发现。然而，当这些发现存在时，或在成像窗口有限的患者中，应进行产后评估以排除其他原发性心脏病。
{"title":"The Clinical Significance of Non-Ebsteinoid Fetal Tricuspid Valve Regurgitation","authors":"Daniel O'Meara MD , Erik C. Michelfelder MD , Andrew Jergel MPH , Sanghee S. Ro MD","doi":"10.1016/j.echo.2025.08.019","DOIUrl":"10.1016/j.echo.2025.08.019","url":null,"abstract":"<div><h3>Background</h3><div>Tricuspid regurgitation (TR) is commonly identified via fetal echocardiography (FE). The association of TR in the fetal heart with neonatal outcomes remains poorly understood. We aimed to assess the spectrum and evolution of non-Ebsteinoid TR in fetuses and to understand the associated clinical outcomes in the current era.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of all fetuses diagnosed with non-Ebsteinoid TR at a single center from January 1, 2012, to October 1, 2023. Eligible fetuses were divided into 3 groups based on the severity of TR on initial FE: mild, moderate, and severe. Initial and serial FE were reviewed along with postnatal echocardiographic findings. Prenatal variables and neonatal outcomes were also collected.</div></div><div><h3>Results</h3><div>A total of 67 fetuses met the inclusion criteria. Based on initial FE, 49 (73.1%) fetuses had mild TR, 15 (22.4%) had moderate TR, and 3 (4.5%) had severe TR, diagnosed at a median gestational age of 26.3 weeks [23.4, 32.3]. Of fetuses with mild TR that had worsening TR in utero (17.9%) or postnatally (17.6%), all had tricuspid valve (TV) dysplasia or right ventricle (RV) dysfunction noted prenatally. Compared to fetuses with mild TR and normal TV anatomy, fetuses with mild TR and TV dysplasia had larger TV annuli (1.12 cm vs 0.96 cm; <em>P</em> = .035) and RV internal diameter in diastole (1.59 cm vs 1.26 cm; <em>P</em> = .01). Newborns with prenatally diagnosed severe TR were more likely to require cardiac intensive care after birth (3/3 = 100%; <em>P</em> < .001) than those with mild (1/49 = 2%) or moderate TR (1/15 = 6.7%).</div></div><div><h3>Conclusions</h3><div>In the absence of TV dysplasia or RV dysfunction, mild, non-Ebsteinoid fetal TR can be considered a benign finding in the current era. However, when these findings are present, or in the patient with limited imaging windows, postnatal evaluation should be performed to rule out other primary cardiac disease.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 1","pages":"Pages 89-98"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 1","pages":"Pages 55-57"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146460667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 2","pages":"Pages 156-166"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147097058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号